MEDICARE: PETER R COLEMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0505X	Adult Medicine Physician	0101037152	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A982	OTHER	VA	GROUP MEDICARE P-TAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760449193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER R COLEMAN MD

Provider Business Mailing Address
First Line	:	204 N HAMILTON ST
Second Line	:	SUITE B
City	:	RICHMOND
State	:	VA
Zip	:	23221-2662
Country	:	US
Telephone Number	:	804-353-1230
Fax Number	:	804-353-3342

Provider Business Practice Location Address
First Line	:	204 N HAMILTON ST
Second Line	:	SUITE B
City	:	RICHMOND
State	:	VA
Zip	:	23221-2662
Country	:	US
Telephone Number	:	804-353-1230
Fax Number	:	804-353-3342

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	06/22/2012

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Directions to “ PETER R COLEMAN MD” Practice Location

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